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Becker’s Healthcare Podcast
Growth, Collaboration, and Real-World AI in Orthopedics with Andrew Lovewell of Columbia Orthopaedic Group
00:14:42
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- [00:03]
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Francesca Matthews
Hello everyone. This is Francesca Matthews with the Beckers ASC Review Podcast. I'm thrilled to be joined today by Andrew Lovewell, Steve CEO at Columbia Orthopedic Group. Thank you so much for being here today.
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Andrew Lovewell
Yeah, thank you so much. I'm looking forward to our discussion today.
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Francesca Matthews
Yeah. Excellent. Just to start off, could you please introduce yourself and tell us a little bit about your background?
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Andrew Lovewell
Yeah. My name's Andrew Lovewell. I am the Chief Executive Officer for Columbia Orthopedic Group. We're a large MSK ortho practice in Columbia, Missouri. We own a surgery center, DME Pharmacy imaging center, just about anything you could imagine that touches one of our patients. We have a full comprehensive offering for all of our patients. Prior to this role, I actually worked for our group currently running our surgery center before and then I was with an academic medical center before that and then with an academic hospital before that. Been in healthcare for about 16 years in various different roles, and it's a complicated puzzle that we all get to try to solve every day. So looking forward to talking about some of that stuff.
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Francesca Matthews
Absolutely. Complicated puzzle for sure. Just to dive right in here, what are the top three trends that you're following in healthcare and ASCS today?
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Andrew Lovewell
Yeah, I think, you know, if anybody comes on the podcast and doesn't talk about AI as a top three trend, they might not be reading any of your guys's publications. But AI is a huge one for us. You know, we're trying to figure out where does it land, where is the utility, how far do we go? You know, do you start small? Do you go all in? What elements do you kind of, kind of start with in your practice? You know, is it scheduling or pre cert or faxing or all those kind of task oriented things that an AI bot or something can help with? You know, past that, I would say the payer landscape for me is a big one. Dealing with commercial contracts and payers and looking at how they structure deals and payer Policies change the landscape completely. You know, UnitedHealthcare just came out and said they're cutting their CRNA reimbursement by 15% coming up. Obviously that's not a shocker for us, but you know, it is now. We have to, you know, react to that type of news. And then I would say outside of that past the payer issues, it, it's just the mergers, acquisitions, private equity, all of those things trying to keep up with all the transactions that are occurring out in the marketplace and being aware of what the trajectory of the healthcare landscape looks like. So there's a lot on our plates, you know, obviously as healthcare leaders today. But you guys at Becker's do a great job with providing information and insight and that's an easy way to kickstart your day with some of the articles that are there, they're quick, they're easy to read and I think that staying informed is nice with your guys platform. But really I'd say one of the biggest resources we all have too is our network of colleagues and talking to them about all these emerging things and getting a take on, hey, what are you trying for AI? What are you doing? You know, just crowdsourcing. Some of that stuff is extremely valuable.
- [04:21]
Francesca Matthews
Absolutely. And you know, always appreciate the love for Becker's and all of our insights and content come directly from providers like yourself. So I think definitely what you said there about that network is, you know, one of the most valuable tools that folks have and figuring out the complicated puzzle of health care. And just to kind of follow up a little bit on the AI component. I'm curious, I've had this conversation with a few folks recently, but how do you at your practice, how are y' all thinking about AI and kind of how are you distinguishing between a meaningful implementation and something that is maybe just a little bit of hype and not something that's actually going to be effective?
- [04:59]
Andrew Lovewell
Well, I think that that's a good question. You know, like where we're at with AI is not where we're going to be, you know, in six months, a year. I think that our perspectives today on AI are very different than the future perspective we're going to have. You know, I think that AI is a novelty at this point in time. Maybe I'm a complete idiot for thinking that, but we quite really understand what is AI and what is an AI. I think it's become this like thrown around buzzword that we're all very excited to talk about. We all think there's like, you know, something out there I don't think it's going to ever replace the human to human interaction that we have with, you know, patients and physicians in the room. It's just not going to happen. So where we have to get is we have to supplement or augment, you know, some of the remedial task work involved with medicine today so we can get back to actually treating patients. And, and if we can use AI to do that, you know, that's a game changer. I think that what we as a medical society or healthcare society have kind of recognized is that there's a lot of work that happens that is very, it just gets in the way of providing care. You know, like peer to peers are one of those things that are just a significant frustration for clinicians and providers all over the country. Dealing with denials and prior auths are a huge problem. Just sorting through faxes alone is like just a nightmare. You know, our organization, about 50,000 faxes a month. I can't even believe that that's a technology we still leverage today. It has its utility for sure, AI does. You know, we just have to figure out which avenue you plug that into. And then we also have to figure out how we define what is AI versus what's, you know, machine learning or large language models or stuff like that. Because not everything is truly AI and I think that that's a challenge that, you know, and, and it's not a knock on the vendors, but if any vendor out there, they pivoted to AI inside of the last two years, they all got it in their branding and messaging. And you know, I, I don't know that I saw very many booths up there this year that didn't have an AI type flare to them.
- [07:24]
Francesca Matthews
Yeah, definitely. I'm hearing what you're saying is just echoed with other ASC leaders I've talked to. There's kind of a cautious optimism for sure there. And you know, you mentioned kind of what's, what's exciting. I'm curious, what, what are you most excited about right now in the ASC space?
- [07:40]
Andrew Lovewell
Yeah, I think in the ASC space, you know, obviously I've been on the podcast a few times, been up there and, and talked to Becker's. You know, the ASC space is, it's still prime for growth. You're gon continue to see more stuff shift to the asc. You know, CMS put out something where they're talking about getting rid of the inpatient only list altogether. Now I don't know that that's, I have cautious optimism on that as well. There's some stuff that honestly we shouldn't do in the asc. There's a lot of stuff we can, you know, because it's safe. You know, I think years ago people never thought we'd be doing anterior lumbar fusions in the asc. Well, we do those today in our asc. Total joints. Another one, you know, Medicare approved us doing those. And now that kind of the barns out of the horse there, like everyone's off to the races doing that. So I think for us it's the continuing evolution of, you know, medicine and how technology and innovation can continue to see us move more stuff, more cases into a lower cost, higher value environment. And what that does for patients, what that does for, you know, Medicare, what that does for self funded employers across the U.S. that's a big deal. I also think you're going to see extremely more effort from health systems and also private equity firms to get into this ASC space even more than what we're seeing now. You know, you're seeing Bain Capital insert your partners, their deal broke up. But I don't think that anything there is is conclusively done until, you know, something else happens. It's just a matter of time before we see more activity in our, in the market. With ASCs, it's, they're ripe, you know, we are by far the, the biggest opportunity, I would say, to kind of bend the cost curve of medicine at this point.
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Francesca Matthews
Yeah, absolutely. And zooming out a little bit, is there anything you mentioned? There's some excitement around AI, but what in healthcare, broadly speaking, are you excited about right now?
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Andrew Lovewell
I think I'm kind of a naturally pessimistic person by nature, but I think the things I get excited about are working with other people around how we develop interdisciplinary plans to grow. You know, is that through mergers? Is that through collaborations? You know, what can we do together instead of separately? Because there's a lot of, it's a lot of marketplaces that are out there where they're very fragmented and people don't work together. And I think that that's very detrimental for not only patients, but also for your contracts. I see. You know, you could look in your guys's publications or just Google on the Internet. The amount of orthopedic groups in the US that have merged inside the last 10 years. Like people are recognizing that there's strength in numbers and value in collaboration. So I see that being a continued effort from like specialties, you know, dermatology's done this opto ortho it's going to continue to happen. I also think one of the most exciting things we can do is work with the employers, the people actually paying the bills to set up steerage programs and networks to get patients to the right place at the right time at the right dollar. You know, a lot of self funded employers that are out there today, they're not going to be able to continue to afford health insurance in the near future. So you know, there's this whole concept of these smaller community health plans that are popping up and creating these narrow high value networks where patients can access care at a very low, in like a very low entry point for cost, but a high value for an outcome. So I see those continuing to pop up. There's one out there now that the Ortho Forum has founded called the Ortho Value Network that's extremely productive. There's a lot of referrals that come through that, that employers are kind of latching onto because they're seeing, wow, look at these private 100 orthopedic groups that are out here that have formed this network to where we can get patients in low cost, high value settings. And it's going to work. It's absolutely going to work. So I see those as being the big ones out there. Just continued collaboration and effort to kind of marry business and healthcare and all those things together to result in a better outcome for everyone.
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Francesca Matthews
Yeah, absolutely. You're speaking to a number of pertinent issues in healthcare there. And you also mentioned growth and thinking about growth. I'm curious how you and your organization are thinking about growth over the next 12 months.
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Andrew Lovewell
Yeah, I think for us, you know, we, we've grown a lot just really in the last two to three years. You know, our, our energy is mainly spent on a couple things. One is continuing to shore up and develop our ancillaries because that's a significant opportunity for revenue with inside of our practice. The second thing there is gaining market share in not only our market but adjacent markets. So you know, what does that look like? Does that, is that a partnership with a hospital to where we become their orthopedic partner of choice? Is that a, you know, where you have orthopedics and we can help co manage that? You know, how does that structure kind of fit with us and then you know, we're not immune to the other things that are out there in the marketplace. You know, we've bought a few practices, we'll continue to look at things in a very realistic perspective. You know, the acquisitions that we've made. I would say that everyone won in those deals. You know, the physicians that were there now make more money because they are on our contracts. They're not managing their practice. You know, we had one practice we bought where the doc was paying bills at 2 o' clock in the morning and trying to make his payroll for his employees. You know, and it's. And that's just wears on you. You know, you can't be productive when you're doing something like that. So, you know, there's a, there's a lot of opportunity out in the marketplace, but we all just have to kind of put the ego aside and say, okay, what can we do together? But I think that's the fastest way we're going to continue to grow is just being very, very real about the process and talk through all of the elements that are involved and be transparent and, you know, just go to work. That's, that's, that's our strategy.
- [14:22]
Francesca Matthews
Yeah, absolutely. Doing, doing more together is something we say here at Becker's as well. So definitely, definitely hear you on that one. And that's actually all I have for you today. Andrew, thank you so much for joining us. It has been a pleasure speaking with you, and I look forward to connecting with you again in the future.
- [14:38]
Andrew Lovewell
Sounds great. Thank you so much for having me.